| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,140.00 | $4,140.00 | $4,140.00 | |
Cigna
| Facility | $566.59 | $566.59 | $566.59 | |
Cigna
| Professional | $448.93 | $561.16 | $566.59 | |
Providence
| Facility | $566.59 | $566.59 | $566.59 | |
Providence
| Professional | $390.75 | $468.90 | $566.59 | |
United
| Professional | $164.12 | $164.12 | $390.75 |